Direct and Indirect Effects of a Couple-Focused Preventive Intervention on Children's Outcomes: A Randomized Controlled Trial With African American Families

Objective: This study examined the effects of the Protecting Strong African American Families (ProSAAF) prevention program on children's outcomes more than 2 years after enrollment, including direct effects of the intervention and indirect effects through couple functioning and parent-child relations. Method: Three hundred forty-six African American couples with an early adolescent child participated; all families lived in rural, low-income communities in the southern United States. Families were randomly assigned to ProSAAF or control conditions and completed four waves of data collection. Couples reported couple functioning at baseline (Wave 1) and at 9-month follow-up (Wave 2), and parent-child relations at 17-month follow-up (Wave 3). Children reported their conduct problems, affiliation with deviant peers, substance use, sexual onset, depressive symptoms, and self-control at 25-month follow-up (Wave 4). Results: Path analyses indicated significant indirect effects of ProSAAF on children's outcomes through improvements in couple functioning and better parent-child relations. There were no significant direct effects of the intervention on children's outcomes or significant indirect effects through couple functioning alone. Conclusions: This couple-focused prevention program has positive indirect effects on several child outcomes through the intervening processes of promoting improvements in couple functioning and better parent-child relations. These findings provide cautious optimism regarding the possible benefits of couple-focused programming on participants' children while suggesting ways in which future couple-focused interventions could yield stronger effects on these youth. What is the public health significance of this article? This study demonstrates that a couple-focused prevention program improves couple functioning and in turn promotes better parent-child relations and child psychosocial functioning two years after enrollment. These findings are important in suggesting that couple-focused programming can yield small benefits for children's long-term outcomes when they enhance couple and parent-child relationships.